Highlights from day one of ABM 2010

We’re in San Francisco for ABM 2010, and the energy is extraordinary. This is the biggest conference in the organization’s 15-year history, with more than 400 physicians and health team members gathering to further the Academy of Breastfeeding Medicine’s mission of promotion, protection and support of breastfeeding and human lactation,

We kicked off the day with a presentation from Suzanne Haynes, senior science advisor for the Office on Women’s Health. Dr. Haynes shared public comments for the forthcoming Surgeon General’s Call to Action of Breastfeeding, expected out next month. Key themes from pubic comments included support for workplace breastfeeding, paid maternity leave, and improved maternity care through the Baby Friendly Hospital Initiative. She emphasized Dr. Regina Benjamin’s commitment to breastfeeding, particularly to addressing disparities in breastfeeding rates.

The scientific sessions began with Peter Hartmann, a breastfeeding researcher from Australia who leads the Human Lactation Research Group. Hartmann took issue with the recent New York Times story on breastpump coverage, stating, for the record, “Breastmilk is not orange juice,” to widespread applause. He reviewed state-of-the-art research on how milk is made — and how much we still need to learn. He noted that the lactating breast uses more energy than the brain — but only 200 researches study the breast, compared with 38,000 neuroscientists.

After Hartmann’s talk, gastroenterologist Michael Haight explored the biology of cow’s milk allergy and intolerance in breastfed infants. He does not recommend mothers pump and dump on an elimination diet for days or weeks for an infant with bloody stools — in his experience, eliminating allergens and continuing to breastfeed is sufficient.

The morning concluded with abstract presentations that will be published in the next edition of ABM’s peer-reviewed journal, Breastfeeding Medicine. Marnie Rowan reported on an Australian study of women with painful nipples, and reported that 1/3 of mothers with minimal visible trauma had positve cultures for Staph Aureus. A. Ali Basma of Minia University in Egypt reported that both mature human milk and colostrum killed the parasites E. histolytica and Giardia lamblia in vitro, but artificial milk substitutes had no effect. Ann Kellams of the University of Virginia reported on breastfeeding and cognition. In a study of 1050 infants, she found that breastfeeding was linked with higher IQ, but not after adjusting for quality of the home environment, maternal parenting attitudes and IQ, breastfeeding was no longer an important predictor. Finally, Leslie Parker presented work from a pilot study of mothers of very low birthweight infants, where she found that starting pumping within the first hour after birth, rather than at 1-6 hours, greatly increased milk supply at 3 and 6 weeks.

The afternoon included talks by Robert Lawrence on breastfeeding and viral illness, Roberto Gugig on early exclusive breastfeeding among WIC moms in San Francisco, and Vanessa Sakalidis on ultrasound studies of infant sucking in early lactation.

The day wound up with Larry Grummer-Strawn’s overview of major US policy changes for breastfeeding in 2010. He discussed health care reform’s mandated pump breaks for hourly workers, which is modeled on Oregon’s workplace breastfeeding law. Notably, in Oregon, no businesses have been granted a hardship exemption for accomodating pumping, and both Grummer-Strawn and Haynes stated that the expectation was that all businesses would find solutions to accomodate nursing mothers.

Grummer-Strawn emphasized that US breastfeeding policy will focus on removing barriers to breastfeeding, not simply exhorting mothers to do it more and longer. The forthcoming surgeon general’s report will target issues such as access to lactation care, maternity practices and maternity leave to ensure that mothers can achieve their feeding goals. Similarly, the proposed Healthy People 2020 goals are not simply about rates, but will track workplace lactation support, unnecessary hospital supplementation of breastfed infants and the number of births at Baby Friendly Hospitals. Grummer-Stawn also alluded to a recent expert panel on improving maternity care and consideration of state programs to link Medicaid reimbursement to Baby Friendly Hospital Certification.

The energy here is palpable — and the best part, as always, is the chance to interact with colleagues who share an unflagging commitment to providing evidence-based care so that every mother can achieve her breastfeeding goals. This is my fifth ABM annual meeting, and it’s a highlight of my year. I’ve already put ABM 2011 on my calendar. Save the data — we’ll be in Miami November 3-6, 2011.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician, breastfeeding researcher, and assistant professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine. She is a member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Dear Alison, many thamnks for your complete review on whta happened on day 1º of the ABM conference. I must confess that being there and hearing such wonderful bright lecturers would have been my dream accomplished.
Nevertheles reading your comments is very instructful and me to I’ll hope we can meet in Miami’s next year conference.
Many thanks your mail was sent to our BF discussion list of the Society of pediatrics in Argentina.